What are the responsibilities and job description for the Workers' Compensation Claims Adjuster position at TCA Consulting Group Inc.?
6 month contract, could go longer or perm
Job Overview
We are seeking a dedicated and detail-oriented Workers' Compensation Claims Adjuster to join our dynamic team. In this role, you will be responsible for managing workers' compensation claims from initial report through resolution, ensuring fair and timely settlements while adhering to legal and company standards. The ideal candidate will possess strong analysis skills, expertise in workers' compensation law, and a commitment to delivering exceptional customer service. This position offers an opportunity to contribute significantly to our claims management process, supporting injured workers and maintaining the integrity of our claims operations.
Responsibilities
- Investigate and evaluate workers' compensation claims by reviewing medical reports, accident reports, and relevant documentation to determine claim validity.
- Negotiate settlements with claimants, healthcare providers, and legal representatives to reach equitable resolutions efficiently.
- Detect potential fraud or suspicious activities through thorough analysis and fraud prevention techniques.
- Utilize financial software to process payments, reserve allocations, and maintain accurate claim records.
- Apply auto estimating tools when assessing vehicle-related injury claims to ensure precise cost evaluations.
- Maintain organized case files, document all claim activities accurately, and ensure compliance with workers' compensation law.
- Communicate effectively with injured employees, employers, medical providers, and legal teams to facilitate smooth claims handling.
- Analyze complex data sets to identify trends or issues that could impact claim outcomes or organizational risk management.
- Support continuous improvement initiatives by recommending process enhancements for efficiency and accuracy.
Qualifications
- Proven experience as a workers' compensation claims adjuster or in a similar role within insurance or risk management.
- Strong knowledge of workers' compensation law and regulatory requirements across jurisdictions.
- Proficiency in using financial software and claims management systems.
- Excellent analysis skills with the ability to interpret medical reports, legal documents, and financial data.
- Skilled in negotiation techniques to achieve fair settlements while managing organizational risk.
- Demonstrated customer service skills with an empathetic approach toward injured workers and stakeholders.
- Organizational skills capable of managing multiple complex cases simultaneously while maintaining attention to detail.
- Familiarity with auto estimating tools is desirable but not mandatory. If you are committed to fairness, accuracy, and professional growth within the workers' compensation field, we encourage you to apply today. Join us in making a meaningful difference by supporting injured employees through effective claims management.
Pay: $30.00 - $31.00 per hour
Work Location: Remote
Salary : $30 - $31